PACIFICA VINTAGE PARK LLC (NPI# 1851990691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851990691 |
| Entity Type | Organization |
| Organization Name | PACIFICA VINTAGE PARK LLC |
| Practice Address |
7230 Gagnier Blvd Las Vegas NV 89113-4400 |
| Practice Telephone | 7022636313 |
| Mailing Telephone | 7022636313 |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2020-10-22 |
| Authorized Official Name | DEEPAK ISRANI (OWNER) |
| Authorized Official Telephone | 6192969000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311500000X | Alzheimer Center (Dementia Center) | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Legacies Memory Care At San Martin | Doing Business As Name - Organization |
| Street Address |
7230 GAGNIER BLVD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89113-4400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871892885 | Touro University | Internal Medicine | 7230 Gagnier Blvd, Willow Creek Memory Care-san Martin, Las Vegas, NV 89113-4400 | 2011-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457951121 | Trang Thu Tran | Pharmacist | 7200 Arroyo Crossing Parkway, Las Vegas, NV 89113 | 2020-10-30 |
| 1457966293 | Cory Alexander Stattelman | Physical Medicine & Rehabilitation | 5575 N Durango Dr Suite 111, Las Vegas, NV 89113 | 2020-09-09 |
| 1477170801 | Hailey Eileen Wilson | Behavior Technician | 5575 S Durango Dr #102, Las Vegas, NV 89113 | 2020-07-01 |
| 1295385078 | Dominica Zaragoza | Technician | 711 S. Durango Dr, Las Vegas, NV 89113 | 2019-09-13 |
| 1831742758 | Lyass PC A Professional Medical Corp | Clinic/Center | 5950 S. Durgango Dr, Suite 100, Las Vegas, CA 89113 | 2019-07-19 |
| 1932679529 | Kiara Hayden | Rehabilitation Practitioner | 5509 Lonesome Biker Lane, Las Vegas, NV 89113 | 2018-11-27 |
| 1437631876 | James Eugene Hightower | Community Health Worker | 7455 Arroyo Crossing Pkwy Suite 220, Las Vegas, NV 89113 | 2018-09-01 |
| 1356822282 | Warda Ali | Nurse Practitioner | 8738 Pinley Spring St, Las Vegas, NV 89113 | 2018-08-28 |
| 1063992949 | Endure Recovery Services LLC | Counselor | 3087 E. Warm Srpings, Suite 200, Las Vegas, NV 89113 | 2018-08-20 |
| 1134635097 | Mivip Regional Surgery Center | Clinic/Center | 5950 S Durango Dr Ste 101, Las Vegas, NV 89113 | 2017-12-14 |
| Find all providers in zip 89113 | ||||
| Taxonomy Code | 311500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Alzheimer Center (Dementia Center) |
| A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer’s Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649885302 | Peace of Mind LLC | Alzheimer Center (Dementia Center) | 4354 E Harmon Ave, Las Vegas, NV 89121-6514 | 2020-09-10 |
| 1144843277 | Vabj LLC | Alzheimer Center (Dementia Center) | 2021 Sedona Morning Dr, Las Vegas, NV 89128-8484 | 2020-05-23 |
| 1376188748 | Bermuda Memory Care | Alzheimer Center (Dementia Center) | 9063 Hunting Arrow St, Las Vegas, NV 89123-7446 | 2019-11-09 |
| 1306405808 | As Time Goes By | Alzheimer Center (Dementia Center) | 4240 Al Carrison St, Las Vegas, NV 89129-4845 | 2019-06-08 |
| 1063071728 | As Time Goes By | Alzheimer Center (Dementia Center) | 4149 Jory Trl, Las Vegas, NV 89108-5206 | 2019-06-06 |
| 1518526268 | As Time Goes By | Alzheimer Center (Dementia Center) | 4125 N Butler St, Las Vegas, NV 89129-4864 | 2019-06-06 |
| 1780240572 | Jai Group LLC | Alzheimer Center (Dementia Center) | 9708 Enniskeen Ave, Las Vegas, NV 89129-8001 | 2019-05-16 |
| 1275198749 | Elkhorn Jones Memory Care LLC | Alzheimer Center (Dementia Center) | 6017 Elkhorn Rd, Las Vegas, NV 89131-3019 | 2019-05-09 |
| 1790243905 | Rci Facilities, LLC | Alzheimer Center (Dementia Center) | 6085 S Lamb Blvd, Las Vegas, NV 89120-2315 | 2019-03-06 |
| 1740748144 | Golden Years Residential Care, LLC | Alzheimer Center (Dementia Center) | 2945 Maverick St, Las Vegas, NV 89108-3907 | 2019-03-05 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.